Individual provider Active NPI

Brenda M Woodhouse

  • Massage Therapist
  • West Valley, UT
National Provider Identifier
1053942466
Registry record updated Feb 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
10766479-4701 Issued in UT
Practice address
6104 W Ginny Cir
West Valley, UT 84128-2530
Phone
(801) 824-1563
NPI assigned
Feb 4, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X
Massage Therapist 225700000X 10766479-4701 UT Primary

Addresses

Primary practice location

6104 W Ginny Cir
West Valley, UT 84128-2530

Mailing address

6104 W Ginny Cir
West Valley, UT 84128-2530
Phone (801) 824-1563

Other practice location 1

70 W Canyon Crest Rd
Alpine, UT 84004-1964
Phone (801) 824-1563

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
10766479-4701UTMDMassage Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1580774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580774400000",
    "number": "1053942466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6104 W GINNY CIR",
            "city": "WEST VALLEY",
            "state": "UT",
            "postal_code": "841282530",
            "telephone_number": "801-824-1563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6104 W GINNY CIR",
            "city": "WEST VALLEY",
            "state": "UT",
            "postal_code": "841282530",
            "telephone_number": "801-824-1563"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "70 W Canyon Crest Rd",
            "address_purpose": "LOCATION",
            "city": "Alpine",
            "state": "UT",
            "postal_code": "840041964",
            "country_code": "US",
            "telephone_number": "801-824-1563",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOODHOUSE",
        "first_name": "BRENDA",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-04",
        "last_updated": "2020-02-04",
        "certification_date": "2020-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "UT",
            "license": "10766479-4701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Valley, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.